Prevalence and Factors Associated with Current Cigarette Smoking among Ethiopian University Students: A Systematic Review and Meta-Analysis

Prevalence of tobacco smoking and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Introduction

The public health concern of tobacco smoking is more prevalent in low- and middle-income countries including Ethiopia. Various studies have investigated tobacco smoking in various parts of Ethiopia. However, the findings have been inconsistent and characterized by significant variability. Besides, there is no nationally representative data on the subject, which could deter the design of effective intervention strategies to reduce tobacco-related problems. Therefore, this study aimed to estimate the pooled prevalence of tobacco smoking and associated factors among adults in Ethiopia.

Methods

The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Guideline. A detailed search was conducted from international databases including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google Scholar. The extracted data was analyzed using STATA 14 software. A random-effects model was used to estimate the effect size. The Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively.

Results

A total of 32 studies with 69,897 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime tobacco smoking among adults in Ethiopia was 16.0% (95% confidence Interval (CI): 13.6-18.39) and there was significant heterogeneity among the included studies (I2 = 99.1%, p < 0.001). Male adults were three times more likely to smoke tobacco as compared with females [OR = 3.22 (95% CI: 2.06-5.03)]. Being an alcohol user [OR = 3.78 (95%CI: 1.27-11.24)] and having tobacco-smoking friends [OR = 7.21 (95%CI: 5.56-9.35)] are potential determinant factors for tobacco smoking.

Conclusion

The pooled prevalence of lifetime and current tobacco smoking among adults in Ethiopia was high, which calls for urgent intervention. Therefore, prioritization of tobacco control strategies, such as creating awareness about the public health importance of tobacco smoking, can help prevent and mitigate the effects of tobacco smoking. Alcohol control law enforcement should also be strengthened.

Prevalence of smoking and its associated factors among students of the University of Dongola, Northern State, Sudan: a cross-sectional study

Background

Smoking is one of the leading causes of morbidity and mortality worldwide, and its prevalence has increased globally, particularly among university students.

Objective

The study aimed to assess the smoking prevalence and its associated factors among students at University of Dongola, Northern State, Sudan.

Methods

A multi-centred cross-sectional study was conducted among students of University of Dongola. Data was collected via an online Google form questionnaire. Descriptive and comparative analyses were performed using SPSS, version 26. Statistical significance was considered at p less than or equal to 0.05.

Results

A total of 642 students participated in the study, of which 51.9% were females. Most of the students (73.6%) were aged 20-25 years and came from health & medical faculties (60.7%). The overall prevalence of smoking was 11.7%. The determined risk factors for smoking included male gender (P≤0.001), older age (P≤0.001), non-health and non-medical faculties (P≤0.001), uneducated fathers (P=0.032), and low socio-economic status (P=0.001). The most common reason for smoking was stress (36%), with cigarettes being the most commonly used type (88%). Personal savings were the main source of smoking expenses (73.3%). Most smokers (88%) were aware of the harmful effects of smoking.

Conclusion

The overall smoking prevalence was relatively low among students at University of Dongola. Male gender, older age, non-health and non-medical faculties, uneducated fathers, and low socio-economic status were significant risk factors for smoking. The majority of smokers were aware of the harmful effects of smoking.

Prevalence and risk factors for tobacco, khat, and alcohol consumption among high school students in Ethiopia

BACKGROUND

Tobacco, khat, alcohol, and marijuana are the main risk factors for non-communicable diseases. There are limited studies on substance use in Ethiopia, especially among secondary school students. This study aims to determine the epidemiology of substance use among secondary school students in Ethiopia.

METHODS

This cross-sectional study was conducted in March 2020 in four large regions of Ethiopia and the capital Addis Ababa. We collected data from 3,355 grade 9 and grade 10 students in 36 randomly selected high schools. Data were collected on tobacco, khat, alcohol and other substances. Mixed effect logistic regression models were fitted to determine the predictors of cigarette smoking.

RESULTS

157 (4.7%) of the participants ever smoked cigarettes and 81 (2.4%) were current smokers. 106 (3.2%) ever used smokeless tobacco, 1,342 (41.8%) had ever drunk alcohol, 290 (8.7%) ever used khat, 137 (4.8%) chewed khat regularly and 76 (2.3%) ever used marijuana. There was a significant regional variation in substance use patterns; cigarette and khat use was the highest in southern regions, whereas alcohol use was highest in the northern areas. Availability of cigarette and khat shops within a 100-meter radius of the school compound was reported by 1,229 (37.5%) and 816 (25%) students, respectively. Three hundred fifty-four (10.9%) students had ever seen someone smoking a cigarette in the school compound. Ever use of smokeless tobacco (Adjusted Odds Ratio (AOR) = 9.4, 95%CI: 4.9-17.9), ever use of shisha (AOR = 8, 95% CI: 3.9-16.3), ever use of khat (AOR = 4.1, 95%CI: 2.5-6.8), ever use of alcohol (AOR = 2.3, 95%CI: 1.4-3.7), having a friend who smoked a cigarette (AOR = 2, 95%CI: 1.2-3.5), and ever seen someone smoking a cigarette in the school compound (AOR = 1.9, 95%CI: 1.1-3.4) were associated with ever use of cigarettes.

CONCLUSION

Substance use prevalence in Ethiopia has regional variations and prevention strategies should be tailored to the needs of the regions. Although this study reported a lower prevalence of cigarette smoking, students could access cigarettes and khat in nearby school areas. The existing tobacco control laws that prohibit selling tobacco products to children and adolescents under 21 years of age and ban establishing tobacco shops close to school compounds should be enforced.

A qualitative analysis of Ethiopian and Eritrean Americans' initiation and continuation of hookah smoking

Hookah smoking is emerging as a popular social practice and health behavior risk among Ethiopian and Eritrean Americans. This qualitative study was the second phase of a sequential exploratory mixed methods study and examined factors that enable the initiation and facilitate the continuation of hookah smoking among Ethiopian and Eritrean Americans. Semi-structured interviews were conducted with twenty-five Ethiopian and Eritrean American hookah smokers residing in the Washington, DC Metropolitan Area of the United States. Interview questions were guided by the Theory of Planned Behavior and addressed: (1) initiation of hookah smoking, (2) past and current patterns of hookah smoking, and (3) behavioral, control and normative beliefs toward hookah smoking. Several themes were identified under the core constructs of 'factors influencing hookah smoking initiation' and 'factors influencing hookah smoking continuation' such as curiosity, lack of health knowledge, socio-cultural acceptance, accessibility, flavor, physical dependence, physiological effects and social connections. Based on these findings, it is recommended that future prevention activities (e.g. health messages) be embedded into a comprehensive tobacco prevention approach to address individual misperceptions of harm and addiction, community social norms and environmental access around hookah smoking, which contribute to both initiation and continuation in the Ethiopian and Eritrean American populations.

Determinants of good academic performance among university students in Ethiopia: a cross-sectional study

BACKGROUND

Education plays a pivotal role in producing qualified human power that accelerates economic development and solves the real problems of a community. Students are also expected to spend much of their time on their education and need to graduate with good academic results. However, the trend of graduating students is not proportional to the trend of enrolled students and an increasing number of students commit readmission, suggesting that they did not perform well in their academics. Thus, the study aimed to identify the determinants of academic performance among university students in Southern Ethiopia.

METHOD

Institution-based cross-sectional study was conducted from December 1 to 28, 2020. A total of 659 students were enrolled and data was collected using a self-administered questionnaire. A multistage sampling technique was applied to select study participants. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Bivariable and multivariable data analysis were computed and a p-value of ≤0.05 was considered statistically significant. Smoking, age, and field of study were significantly associated with academic performance.

RESULT

Four hundred six (66%) of students had a good academic performance. Students aged between 20 and 24 years (AOR = 0.43, 95% CI = 0.22-0.91), and medical/ health faculty (AOR = 2.46, 95% CI = 1.45-4.20) were significant associates of good academic performance. Students who didn't smoke cigarettes were three times more likely to score good academic grades compared to those who smoke (AOR = 3.15, 95% CI = 1.21-7.30).

CONCLUSION

In this study, increased odds of good academic performance were observed among students reported to be non-smokers, adults, and medical/health science students. Reduction or discontinuation of smoking is of high importance for good academic achievement among these target groups. The academic environment in the class may be improved if older students are invited to share their views and particularly their ways of reasoning.

Bioinsecticide Production from Cigarette Wastes

Tobacco, one of the most significant nonfood crops, is critical to agriculture worldwide. The tobacco processing business creates a significant amount of hazardous tobacco waste containing nicotine, and only a tiny portion of it gets recycled. Nicotine, the primary component of tobacco products such as cigarettes, is an alkaloid and can be used as an insecticide. This research aims to extract nicotine from discarded cigarette butts and utilize it as an insecticide. Extraction, emulsification, and efficiency testing on cabbage aphids are all part of the procedure. The initial extraction tests used a solvent combination of ethanol and methanol in various ratios, with a 3 : 1 ratio yielding the best results. Temperature (30–60°C), extraction length (4–6 hrs), and sodium hydroxide concentration (1–3 M) are the independent variables studied for extraction parameters, and the optimal conditions are determined using Design-Expert, response surface approach central composite design (RSM-CCD). In addition, artificial neural network (ANN) studies with MATLAB were used to accurately forecast extraction yield. The extracted product was evaluated using a gas chromatography–mass spectrometry (GC-MS) and a UV/visible spectrophotometer. The ideal crude extract yield and nicotine content were 17.75 and 3.26%, respectively, at the optimal conditions of temperature 60°C, time 4 hrs, and NaOH concentration 2.83 M with desirability of 0.832. The nicotine extracted was emulsified by combining the crude extract with a combination of palm oil and surfactants. Density, viscosity, pH, flash point, and surface tension of the emulsified concentration were measured and reported as 1.01 ± 0.01 g/ml, 585.33 ± 2.52 mPa s, 9.37 ± 0.03, 87.96 C, and 34.10 mN/m, respectively. On the cabbage aphid, the emulsified concentrated extract performed best at a ratio of 1 : 100 (emulsified concentrated to solvent).